Retroperitoneal pseudomeningocele complicated by meningitis following a lumbar burst fracture. A case report

Spine (Phila Pa 1976). 1996 May 1;21(9):1090-3. doi: 10.1097/00007632-199605010-00020.

Abstract

Study design: This case report demonstrates an unusual complication after anterior decompression and fusion of a lumbar burst fracture.

Objectives: The treatment of this patient involved placement of a computed tomography-guided percutaneous drain and intravenous antibiotics to treat an infected retroperitoneal pseudomeningocele.

Summary of background data: A case of an anterior retroperitoneal pseudomeningocele complicated by meningitis is presented. This pseudomeningocele occurred in a patient after an L3 burst fracture associated with a dural laceration.

Methods: The patient was admitted to the authors' trauma unit after a motor vehicle accident with an acute L3 fracture associated with incomplete paraplegia. He underwent an urgent anterior corpectomy, strut grafting, and instrumentation. At surgery, he was noted to have a large anterior dural laceration. After surgery, a large retroperitoneal pseudomeningocele developed that became infected with Staphylococcus epidermidis.

Results: After placement of a computed tomography-guided percutaneous drain and intravenous antibiotics, the pseudomeningocele resolved. His anterior fusion healed uneventfully and his neurologic deficit improved dramatically.

Conclusions: A case of an anterior retroperitoneal pseudomeningocele complicated by meningitis is presented. This pseudomeningocele occurred in a patient after an L3 burst fracture associated with a dural laceration. The patient was treated successfully with computed tomography-guided percutaneous drain placement and intravenous antibiotics. He made an excellent functional recovery after a severe neurologic injury.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Drainage / methods
  • Drug Therapy, Combination / therapeutic use
  • Humans
  • Lumbar Vertebrae / injuries*
  • Male
  • Meningitis / etiology*
  • Meningitis / therapy
  • Meningocele / etiology*
  • Meningocele / therapy
  • Retroperitoneal Space
  • Rifampin / therapeutic use
  • Spinal Fractures / complications*
  • Spinal Fractures / diagnostic imaging
  • Spinal Fractures / surgery
  • Staphylococcal Infections / etiology*
  • Staphylococcal Infections / therapy
  • Staphylococcus epidermidis / isolation & purification
  • Tomography, X-Ray Computed
  • Vancomycin / therapeutic use

Substances

  • Vancomycin
  • Rifampin